ArticleBMJ open2017
'Just like a normal pain', what do people with diabetes mellitus experience when having a myocardial infarction: a qualitative study recruited from UK hospitals.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 32 citations in OpenAlex.
- Diabetes-associated short-term mortality after first-onset acute myocardial infarction: age- and residence-specific patterns in an underserved region.BMC public health · 2026Article
- Prehospital 12-lead ECG and outcomes in acute coronary syndrome.Heart (British Cardiac Society) · 2026Article
- Symptom Denial and Cultural Constraints: A Qualitative Exploration of Pre-Hospital Delay Determinants in Myocardial Infarction Patients in China.Clinical cardiology · 2026Article
- Pathways of Care for Patients Who Undergo Primary Percutaneous Coronary Intervention for STEMI: A Review of "Reviews in cardiovascular medicine · 2026Review
- Emerging opportunities to target inflammation: myocardial infarction and type 2 diabetes.Cardiovascular research · 2024Review
- Clinical outcomes of myocardial infarction with non-obstructive coronary arteries presenting with diabetic ketoacidosis: a propensity score-matched analysis.European journal of medical research · 2024Article
- Do patients with diabetes with new onset acute myocardial infarction present with different symptoms than non-diabetic patients?Frontiers in cardiovascular medicine · 2024Article
- Delays in Presentation by Patients with ST Elevation Myocardial Infarction: A single centre experience from Oman.Sultan Qaboos University medical journal · 2022Article
- Validity of regional network systems on reperfusion therapy in diabetes mellitus and non-diabetes mellitus patients with ST-segment elevation myocardial infarction.Frontiers in cardiovascular medicine · 2022Article
- Impact of acute diabetes decompensation on outcomes of diabetic patients admitted with ST-elevation myocardial infarction.Diabetology & metabolic syndrome · 2018Article
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3 authors at 3 institutions in 1 country.
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Abstract
objectiveThe objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service.
settingThree London (UK) hospitals (coronary care units and medical wards).
participantsPatients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest). A total of 43 participants were recruited, and 39 interviews met the study criteria and were analysed. They were predominantly male (n=30), aged 40-90 years and white British (18/39), and just over a half were from other ethnic groups. The majority had type 2 DM (n=35), 24 had an NSTEMI, 10 had an STEMI and five had other cardiac events. DEFINITIONS OF SELECTION/EXCLUSION CRITERIA: A diagnosis of MI and DM and the ability to communicate enough English to complete the interview. Ward staff made a clinical judgement that the participant was post-treatment, clinically stable and well enough to participate.
methodsA qualitative study using taped and transcribed interviews analysed using a thematic analysis.
resultsWhile most participants did experience chest pain, it was often not their most striking symptom. As their chest pain did not match their expectations of what a 'heart attack' should be, participants developed narratives to explain these symptoms, including the symptoms being effects of their DM ('hypos'), side effects of medication (oral hypoglycaemics) or symptoms (such as breathlessness and indigestion) related to other comorbidities, often leading to delays in seeking care.
conclusionsWhile truly absent chest pain during MI among people with DM was rare in this study, patients' attenuated symptoms often led to delay in seeking attention, and this may result in delays in receiving treatment.
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